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Application Information      
First Name: Last Name: Address: City:
State: Zip: Email: Social Security #:
Cell Phone: Home Phone:    
   
    Yes No
1. Are you 18 years of age or older?
 
2. Have you previously worked for Williams Island POA?
If yes, please provide dates, position held and supervisor’s name:
 
Dates: Position: Supervisors Name:
 
3. Are you related to an employee? If yes, please specify:
 
4. Are you legally authorized to work in the United States?
 
5. If required, do you meet the legal age requirement in the state of Florida, to serve/handle alcoholic beverages?
 
6. Have you ever been convicted, entered a plea of no contest, had prosecution deferred, or adjudication withheld
for any crime (except for minor traffic violations) which has not been purged or sealed, or is there a criminal
charge pending against you? If yes, please give date and details.
 
 

7.

 Have you ever been terminated from a job involuntarily?

 

Employment Interests      
Position Desired:   Date Available: Salary Desired:
Full-Time Part-Time Seasonal On Call
 
When are you available for work:      
Days Evenings Overnight Weekends Holidays Overtime (if required)
 
Are there any specific times when you are unable to work?   No Yes (please specify)  
   
 
How were you referred to our company?    
Agency Internet Walk-In Re-Hire Advertisement
Employee (name): Other (please specify):  

 

Educational Background        
School Level Name & School Location Course of Study Last Grade Completed Did You Graduate? Degree or Diploma?
           
High School No Yes
   
College
or University		 No Yes
   
Post Graduate No Yes
   
Trade
or Vocational		 No Yes
       
Do you hold any specialized licenses or certifications? If yes, please specify: No Yes  
   
 
Do you speak, read or write any foreign languages? If yes, please specify: No Yes  
Speak: Read: Write:  
 

 

Employment Background      
Employer: Dates Employed: Address: City:
State: Zip: Supervisor's Name & Title: Phone #:
Job Title: Starting Pay Rate: Ending Pay Rate:  
 
Daily Responsibilities:   Reason for Leaving: May we contact your employer?
No Yes
 
 
       
Employer: Dates Employed: Address: City:
State: Zip: Supervisor's Name & Title: Phone #:
Job Title: Starting Pay Rate: Ending Pay Rate:  
 
Daily Responsibilities:   Reason for Leaving: May we contact your employer?
No Yes
 
 
       
Employer: Dates Employed: Address: City:
State: Zip: Supervisor's Name & Title: Phone #:
Job Title: Starting Pay Rate: Ending Pay Rate: May we contact your employer?
No Yes
Daily Responsibilities:   Reason for Leaving:  
 
 
 
       
Employer: Dates Employed: Address: City:
State: Zip: Supervisor's Name & Title: Phone #:
Job Title: Starting Pay Rate: Ending Pay Rate:  
 
Daily Responsibilities:   Reason for Leaving: May we contact your employer?
No Yes

 

Acknowledgement
Please read carefully and check each box.
I understand that Williams Island POA and/or the employing entity is an equal opportunity employer and selects individuals best matched for the job based on job-related qualifications regardless of race, color, religion, sex, national origin, sexual orientation, age or disability.
   
I understand that this application will be given every consideration and will be kept on active status for sixty days, but it is not a promise of employment. Any applicant wishing to be considered for employment beyond 60 days should re-apply.
   
I understand that employment is at will. It can be terminated, with or without cause or notice at any time, at the option of either Williams Island POA or myself. No manager or supervisor has the authority to enter into an employment agreement for any specified period of time or to make agreement contrary to the foregoing without the direct authorization of Williams Island POA.
   
In the processing of my application, an investigation will be made whereby information is obtained from former employers and references. Permission is hereby granted to any school, person, firm or corporation, whether my former employer or otherwise, to give Williams Island POA, its officers, employees, representatives, or agents information regarding my employment or educational history. Any entity providing information will not be held
liable for any damage incurred by myself through the release of requested information.
   
I understand that I will be required to complete a pre-employment drug screening examination administered by a professional laboratory as part of my application for employment to which I also consent. I understand that either refusal to submit to the pre-employment drug screening examination or failure to qualify according to the standards established by the Company for this examination may disqualify me from further consideration for employment. The results of this examination shall be held in confidence and furnished only to the authorized officer of the Company from which I am now seeking employment for use solely in consideration relevant to my employment. I further understand that upon commencement of employment with the Company I may again be required, for reasonable suspicion, or randomly, to submit to a drug screening examination administered by a
professional laboratory. I understand that refusal to take a requested drug screening test or failure to meet the standards set for the examination may result in immediate suspension or discharge.
   
Should I be employed, I understand that such employment will be on a trial probationary period for ninety days from the first date of employment. I further understand that my employment will not result in an employment contract for any specific term.
   
I agree that the Company can withhold wages to cover any shortages or damages that I am responsible for.
   
I understand that if hired, my continued employment is predicated upon the truthfulness and accuracy of the statements contained herein, and that I am subject to termination if any statement in this application is false or misleading.
   
I hereby affirm that the information contained herein is true and correct.
Electronic Application Signature: Date:

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